Dentists' Experiences of Treatment and Referral for Patients With Obesity

Objectives: The prevalence of obesity is increasing and yet dental treatment provision for patients with obesity can be challenging. Obesity can prevent patients from accessing appropriate healthcare services as many treatment facilities cannot accommodate individuals of greater weight, particularly those whose weight exceeds that of a typical dental chair. Patients are sometimes referred to hospital settings or specific clinics with bariatric chairs yet the availability of these is variable. The processes by which weight is discussed and when or if referrals are initiated is poorly understood. This study aimed to explore the perceptions and experiences of dentists involved in the care or referral of patient with obesity to highlight any barriers to optimal care provision for this patient group.
Methods: Semi-structured interviews were untaken with 12 dentists who had either referred or treated patients with obesity in general practice and community dental settings. Interviews were transcribed verbatim and analysed using thematic analysis and a constant comparative approach.
Results: Dentists expressed consistent challenges in treatment provision for patients with obesity. Six key themes arose from the data: awareness of the challenges of obesity, difficulties broaching the topic with patients, challenges in determination of weight, safety concerns and equipment limitations, problems in provision of emergency care, and unclear referral pathways for patients with obesity. From becoming aware patients had obesity to the process of referral or treatment, a complex array of discussions and processes had to be navigated which was perceived to be uncomfortable and unnecessary complex.
Conclusions: Aligned with their safety concerns and desire to offer appropriate care, dentists require guidance on how to approach and discuss obesity with patients. There needs to be a clear and patient-centred pathway by which treatment can be provided in settings which can accommodate patients of higher weights.